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Blood Transfusion

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1. Hydroxyurea for reducing blood transfusion in non-transfusion dependent beta thalassaemias. (PubMed)

Hydroxyurea for reducing blood transfusion in non-transfusion dependent beta thalassaemias. Non-transfusion dependent beta thalassaemia is a subset of inherited haemoglobin disorders characterised by reduced production of the beta globin chain of the haemoglobin molecule leading to anaemia of varying severity. Although blood transfusion is not a necessity for survival, it is required when episodes of chronic anaemia occur. This chronic anaemia can impair growth and affect quality of life (...) . People with non-transfusion dependent beta thalassaemia suffer from iron overload due to their body's increased capability of absorbing iron from food sources. Iron overload becomes more pronounced in those requiring blood transfusion. People with a higher foetal haemoglobin level have been found to require fewer blood transfusions. Hydroxyurea has been used to increase foetal haemoglobin level; however, its efficacy in reducing transfusion, chronic anaemia complications and its safety need

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2016 Cochrane

2. Late erythropoiesis-stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants. (PubMed)

Late erythropoiesis-stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants. Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia. Darbepoetin (Darbe) and EPO are currently available ESAs.To assess the effectiveness and safety of late initiation of ESAs, between eight and 28 days after birth, in reducing the use of red blood cell (RBC (...) for this outcome (RR I² = 66%; RD I² = 58%). The quality of the evidence was very low. We obtained similar results in secondary analyses based on different combinations of high/low doses of EPO and iron supplementation. There was no significant reduction in the total volume (mL/kg) of blood transfused per infant (typical mean difference (MD) -1.6 mL/kg, 95% CI -5.8 to 2.6); 5 studies, 197 infants). There was high heterogeneity for this outcome (I² = 92%). There was a significant reduction in the number

2019 Cochrane

4. Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews. (PubMed)

Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews. Globally, sickle cell disease (SCD) is one of the commonest severe monogenic disorders, due to the inheritance of two abnormal haemoglobin (beta globin) genes. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Red blood cell (RBC) transfusions are used to treat complications of SCD, e.g. acute chest syndrome (ACS) (this often (...) involves a single transfusion episode), or they can be part of a regular long-term transfusion programme to prevent SCD complications.To summarize the evidence in Cochrane Reviews of the effectiveness and safety of RBC transfusions versus no transfusion, or restrictive (to increase the total haemoglobin) versus liberal (to decrease the haemoglobin S level below a specified percentage) transfusion, for treating or preventing complications experienced by people with SCD.We included Cochrane Reviews

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2018 Cochrane

5. Transfusion of red blood cells stored for shorter versus longer duration for all conditions. (PubMed)

Transfusion of red blood cells stored for shorter versus longer duration for all conditions. Red blood cell (RBC) transfusion is a common treatment for anaemia in many conditions. The safety and efficacy of transfusing RBC units that have been stored for different durations before a transfusion is a current concern. The duration of storage for a RBC unit can be up to 42 days. If evidence from randomised controlled trials (RCT) were to indicate that clinical outcomes are affected by storage (...) duration, the implications for inventory management and clinical practice would be significant.To assess the effects of using red blood cells (RBCs) stored for a shorter versus a longer duration, or versus RBCs stored for standard practice duration, in people requiring a RBC transfusion.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PubMed (for epublications), LILACS, Transfusion Evidence Library, Web of Science CPCI-S and four international clinical

2018 Cochrane

6. Blood Transfusion in Trauma: Timing and Product Ratio

Blood Transfusion in Trauma: Timing and Product Ratio Emergency Medicine > Journal Club > Archive > February 2018 Toggle navigation February 2018 Blood Transfusion in Trauma: Timing and Product Ratio Vignette It's an active early spring afternoon in the city, and you're pretty sure that just about everyone and their sister have been shot at, with most of the pour souls ending up in your TCC. As these things tend to go, The GSWs thus far are to the extremities or benign grazes (...) : Trauma patients requring urgent blood transfusion or meeting massive transfusion protocol (MTP) criteria. Intervention #1: Balanced blood transfusion (closer to a 1:1:1 ratio of plasma:platelets:RBCs) Comparison #2: Higher blood to plasma/platelet ratio (i.e. closer to 1:1:2) Intervention #2 : Prehospital blood transfusion by EMS Comparison #2: No prehospital blood transfusion Outcome: Mortality, incidence of transfusion reaction, cost, hospital/ICU length of stay Articles Article 1: Article 2

2018 Washington University Emergency Medicine Journal Club

7. Prophylactic intravenous calcium therapy for exchange blood transfusion in the newborn. (PubMed)

Prophylactic intravenous calcium therapy for exchange blood transfusion in the newborn. Exchange blood transfusion (EBT) is a form of whole blood transfusion in which the total blood volume is replaced within a few hours. In perinatal and neonatal medicine, EBT is most often used in the management of severe anaemia or severe hyperbilirubinaemia in the first week of life. Hypocalcaemia, one of the common morbidities associated with EBT, is thought to arise from the chelating effects (...) of the citrate commonly used as an anticoagulant in the donor's blood. This disorder manifests with muscular and nervous irritability and cardiac arrhythmias.To determine whether the use of prophylactic calcium reduces the risk of hypocalcaemia-related morbidities and death among newborn infants receiving EBT.We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 5), MEDLINE via PubMed (1966 to 29 June 2016

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2017 Cochrane

8. Desmopressin use for minimising perioperative blood transfusion. (PubMed)

Desmopressin use for minimising perioperative blood transfusion. Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed.To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have (...) conditions. These trials were conducted between 1986 and 2016, and 11 were funded by pharmaceutical companies or by a party with a commercial interest in the outcome of the trial.The GRADE quality of evidence was very low to moderate across all outcomes. No trial reported quality of life. DDAVP versus placebo or no treatmentTrial results showed considerable heterogeneity between surgical settings for total volume of red cells transfused (low-quality evidence) and for total blood loss (very low-quality

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2017 Cochrane

9. Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support. (PubMed)

Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support. Many people diagnosed with haematological malignancies experience anaemia, and red blood cell (RBC) transfusion plays an essential supportive role in their management. Different strategies have been developed for RBC transfusions. A restrictive transfusion strategy seeks (...) to maintain a lower haemoglobin level (usually between 70 g/L to 90 g/L) with a trigger for transfusion when the haemoglobin drops below 70 g/L), whereas a liberal transfusion strategy aims to maintain a higher haemoglobin (usually between 100 g/L to 120 g/L, with a threshold for transfusion when haemoglobin drops below 100 g/L). In people undergoing surgery or who have been admitted to intensive care a restrictive transfusion strategy has been shown to be safe and in some cases safer than a liberal

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2017 Cochrane

10. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease. (PubMed)

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease. Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso (...) -occlusion and stroke by diluting the proportion of sickled cells in the circulation.This is an update of a Cochrane Review first published in 2002, and last updated in 2013.To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts).We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980

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2017 Cochrane

11. Seroprevalence of transfusion transmitted infections among blood donors in Gash Barka Zonal Blood Transfusion Center, Barentu, Eritrea, 2014 through 2017. (PubMed)

Seroprevalence of transfusion transmitted infections among blood donors in Gash Barka Zonal Blood Transfusion Center, Barentu, Eritrea, 2014 through 2017. Transfusion-transmissible infections pose a major health risk in developing countries, including Eritrea. In the present study, we sought to determine the prevalence of specific transfusion transmitted infections (TTIs) and the associated risk factors among blood donors at a newly established regional blood transfusion center in Barentu (...) , Eritrea.The seroprevalence of markers for specific TTIs by sex, age, educational status, residence, occupation, and donor type was evaluated for donors who donated blood between July 2014 and April 2017. The relationship between TTIs and the stated factors was evaluated using the Pearson Chi-square test/Fishers exact test. Adjusted and unadjusted binary logistic regression models were employed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the occurrence of TTIs. A two-sided p-value

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2019 BMC Hematology

12. Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: A propensity-matched analysis

Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: A propensity-matched analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

13. Effect of Short-Term vs. Long-Term Blood Storage on Mortality after Transfusion

Effect of Short-Term vs. Long-Term Blood Storage on Mortality after Transfusion PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

14. Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about?

Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? - CanadiEM Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? In , by Matthew Nicholson July 30, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert, Communicator (...) normalizing. Reticulocyte count is 45. There are no signs of bleeding clinically or on ultrasound examination of the abdomen. There is no laboratory evidence of hemolysis. You suspect the patient may be unable to produce adequate RBCs due to inflammation from her injuries and operation. To be safe you send investigations to check nutritional parameters and start folic acid empirically. The patient complains of fatigue and you decide a blood transfusion is indicated. The situation is no longer emergent

2018 CandiEM

15. Blood and Clots Series: Massive transfusion protocol: what is it, why does it exist, and when should I call one?

Blood and Clots Series: Massive transfusion protocol: what is it, why does it exist, and when should I call one? Blood and Clots Series: Massive transfusion protocol: what is it, why does it exist, and when should I call one? - CanadiEM Blood and Clots Series: Massive transfusion protocol: what is it, why does it exist, and when should I call one? In , by Matthew Nicholson July 16, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert Case (...) administration and minimize coagulopathy by administering RBCs, platelets, and plasma in a balanced ratio (approximating 1:1:1 or 1:1:2 per the PROPPR trial) 7 . Administration of either cryoprecipitate or fibrinogen concentrate are also common in MTP. Key Concepts in MTPs The patient remains tachycardic with labile blood pressure despite two units of RBCs and two litres of crystalloid. You decide to activate the hospital’s massive transfusion protocol prior to the results of laboratory tests becoming

2018 CandiEM

16. Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy. (PubMed)

Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy. Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus (...) on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies. This is an update of a Cochrane review that was published in 2013.To assess the benefits and harms of a policy of prophylactic versus selective blood transfusion in pregnant women with sickle cell disease.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 May 2016) and reference lists of retrieved studies. We did not apply any language or date

2016 Cochrane

17. Washed versus unwashed red blood cells for transfusion for the prevention of morbidity and mortality in preterm infants. (PubMed)

Washed versus unwashed red blood cells for transfusion for the prevention of morbidity and mortality in preterm infants. Infants born very preterm often receive multiple red blood cell (RBC) transfusions during their initial hospitalisation. However, there is an increasing awareness of potential adverse effects of RBC transfusions in this vulnerable patient population. Modification of RBCs prior to transfusion, through washing with 0.9% saline, may reduce these adverse effects and reduce (...) the rate of significant morbidity and mortality for preterm infants and improve outcomes for this high-risk group.To determine whether pre-transfusion washing of RBCs prevents morbidity and mortality in preterm infants.We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE via PubMed (31 July 2015), EMBASE (31 July 2015), and CINAHL (31 July 2015). We also searched clinical trials databases

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2016 Cochrane

18. Blood transfusions for treating acute chest syndrome in people with sickle cell disease. (PubMed)

Blood transfusions for treating acute chest syndrome in people with sickle cell disease. Sickle cell disease is an inherited autosomal recessive blood condition and is one of the most prevalent genetic blood diseases worldwide. Acute chest syndrome is a frequent complication of sickle cell disease, as well as a major cause of morbidity and the greatest single cause of mortality in children with sickle cell disease. Standard treatment may include intravenous hydration, oxygen as treatment (...) for hypoxia, antibiotics to treat the infectious cause and blood transfusions may be given. This is an update of a Cochrane review first published in 2010.To assess the effectiveness of blood transfusions, simple and exchange, for treating acute chest syndrome by comparing improvement in symptoms and clinical outcomes against standard care.We searched The Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, which comprises references identified from comprehensive

2016 Cochrane

19. Preoperative blood transfusions for sickle cell disease. (PubMed)

Preoperative blood transfusions for sickle cell disease. Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Surgical interventions are more common in people with sickle cell disease, and occur at much younger ages than in the general population. Blood transfusions (...) are frequently used prior to surgery and several regimens are used but there is no consensus over the best method or the necessity of transfusion in specific surgical cases. This is an update of a Cochrane review first published in 2001.To determine whether there is evidence that preoperative blood transfusion in people with sickle cell disease undergoing elective or emergency surgery reduces mortality and perioperative or sickle cell-related serious adverse events.To compare the effectiveness of different

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2016 Cochrane

20. Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews. (PubMed)

Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews. This is the protocol for a review and there is no abstract. The objectives are as follows: To summarize the evidence in Cochrane reviews of the effectiveness and safety of red cell transfusions versus no transfusion, or restrictive (to increase the total haemoglobin) versus liberal (to decrease the haemoglobin S level below a specified percentage) transfusion, for treatment

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2016 Cochrane

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